What is age-related macular degeneration, and how do you know if you have it?

What is AMD?

Age-related macular degeneration (AMD) is a disease which affects a part of your eye called the macula. The macula is the central part of your retina (situated at the back of your eye) and is responsible for your central vision, colour vision and seeing fine details. It might only be 5mm in diameter but it is an essential part of your eye for good, unimpaired eyesight. AMD affects your macula and therefore impacts your central vision, causing it to degenerate and you to lose your central vision. This makes reading, recognising faces, and using a computer or your phone very difficult. If you suffer with AMD, your peripheral vision remains unaffected as a different part of your retina is responsible for its function. This means that even with advanced AMD attacking your central vision, you should still be able to rely on your peripheral vision.

In the UK, over 600,000 people are affected by AMD. Worldwide, this figure rises to 196 million (8.7% of the global population) and, by 2040, it’s thought that 288 million people will be affected. The figures are expected to rise this sharply as a result of a number of risk factors which are also on the rise. These include smoking, alcohol consumption, and obesity, and we’ll discuss these in more depth later in this piece. It’s a growing problem, with 5% of global blindness occurring as a result of AMD. As the “age-related” part of the name suggests, AMD tends to affect people aged 50 and older, with 1/200 people aged over 60 suffering with it. This rises to 1/5 for 90 year olds so, unfortunately, it’s clear to see that AMD is simply a natural part of the ageing process.

Types of AMD

Although there are several types of macular diseases, there are just two types of AMD: wet and dry. The symptoms for the two are largely the same and include:

• Faded colours
• Words disappearing when you read
• Objects changing shape, size, or colour
• Dark smudges in your central vision
• Straight lines appearing bent
• Finding it difficult to look at bright light

Between 85 and 90% of all instances of AMD are cases of dry AMD which, thankfully, is the less serious form of the condition. This is because any vision loss happens slowly while the macular cells gradually deteriorate, and macular tissues thin. It develops over any time period from several months to years. Unfortunately, there is no treatment available for dry AMD, and up to 15% of dry AMD sufferers go on to develop wet AMD. However, wet AMD can be treated if it’s caught quickly. Rather than your retinal cells slowly dying, as is the case for dry AMD, wet AMD occurs when abnormal blood vessels grow into your macula. The body creates new blood vessels to supply nutrients and oxygen to your retina but, in excess, it actually ends up having a negative effect.

Again, this growth of blood vessels is an age-related process and the newly-formed blood vessels can begin to leak blood or fluid into your macula. This, in turn, can scar the macula and cause your central vision to rapidly deteriorate – even over the course of just a few days. To treat wet AMD, you need to receive specialist treatment as soon as possible, in the form of injections into your eye. This treatment typically lasts for around 3 months, but specialist laser treatment is available as an alternative for patients who don’t respond to the injections.

AMD in its early stages

Detecting AMD can be quite difficult because any loss of vision is so gradual that you may not notice it in the early stages. It’s also painless so there’s nothing to alert you to its presence initially. This is why going for eye tests regularly is crucial, as early diagnosis can really help with further treatment. Most high street opticians have scanning machines in store to help them diagnose early cases of AMD.

Your eye doctor may also suggest that you use an Amsler grid to check on any progression of vision loss.

If you have AMD, you might see some of these lines as blurry or wavy, with dark areas towards the middle of the grid. Performing this exercise on a regular basis, whether that’s weekly or even monthly, allows you track any changes accurately and assess the speed of any visual deterioration.

How to slow the progression of AMD

There are a few steps you can take which are proven to slow the progression of AMD and therefore preserve your eyesight for longer. These actions are particularly effective when you have only just been diagnosed and are yet to experience any loss of vision.

1. Stop smoking. You’re four times more likely to develop AMD if you smoke. This is because smoking kills your retinal cells and prevents nutrients from reaching your eye effectively. You can read more about the effects of smoking on your vision, but bringing on AMD is one of its worst effects when it comes to your eyes.
2. Eat healthily. A diet rich in nutrients like lutein and zeaxanthin helps your eye health and increases the density of macular pigments. Make sure you’re eating enough leafy greens and omega 3. Find out more about the top 10 foods for healthy eyes on our blog and read about how they can boost your eye health.
3. Exercise more. Studies have shown that maintaining a healthy weight and normal blood pressure helps slow AMD’s progression. Obesity is also a key risk factor for developing AMD (double the risk, in fact!), so exercising is a way to help combat that too.

Unfortunately, AMD is also thought to be hereditary with certain genes associated with 74% of AMD cases. There isn’t a lot that you can do about which genes you inherit from your parents but you are entirely responsible for your lifestyle choices – and these certainly do impact your chances of developing AMD.

Attending regular eye tests is the most sensible thing you can do, in order to ensure early diagnosis. From there, you and your eye doctor will be able to track the progression of your AMD and you can receive the best treatment options for you and your vision. Make sure you’re aware of the symptoms, follow the steps to reduce your risk of developing AMD, and contact a specialist if you notice any visual changes.